原发性高血压患者动态脉压、年龄与靶器官损害的关系

Relationship between ambulatory pulse pressure and target organs damage in essential hypertensive patients

目的探讨原发性高血压患者24h 收缩压、舒张压及脉压变化与靶器官损害的关系。方法对296例观察对象进行24h 动态血压监测,其中血压正常组92例,单纯血压升高的原发性高血压患者为原发性高血压组86例,原发性高血压伴靶器官损害患者为伴靶器官损害组118例。296例根据动态平均脉压水平分为3个亚组(脉压<40mmHg 组、40mmHg≤脉压<50mmHg组、脉压≥50mmHg 组),对比分析24h 动态血压监测各指标。将伴靶器官损害组按年龄分为<60岁、≥60岁2个亚组.观察对比24h 动态血压监测各指标的变化。结果 (1)伴靶器官损害组24h收缩压、白昼舒张压、夜间舒张压低于原发性高血压组(P<0.01);(2)随高血压患者病变程度的加重,脉压也随之增大(P<0.01),依次为伴靶器官损害组、原发性高血压组和血压正常组;(3)伴靶器官损害组两年龄间脉压差异无统汁学意义(P>0.05)。结论动态脉压的变化可以反映高血压患者病变程度,舒张压低及动态脉压增大是原发性高血压伴靶器官损害患者动态血压变化特点之一。

Objective To investigate the relationship among 24 h ambulatory systolic pressure （SBP）and diastolic pressure （DBP）, pulse pressure （PP） and target organs damage in essential hypertension patients. Methods Ambulatory blood pressure monitoring （ABPM） were used in 296 cases including 92 patients with normal blood pressure as control group （group Nor）, 86 patients with hypertension （group EH）, and 118 essential hypertensive patients with target organs damage （group EH＋TOD ）. According to the levels of ambulatory pulse pressure, all cases were divided into 3 subgroups （ PP〈40 mm Hg; 40 mm Hg≤PP〈50 mm Hg; PP≥50 mm Hg）,and the cases of the group EH＋TOD divided into 2 subgroups 〈60 years old and ≥60 years old. Then,we analyzed and compared the changes of ABPM parameters among the groups. Results （1）24 h SBP,day DBP, night DBP in group（EH＋TOD）was significantly lower than that in group EH （P〈0. 01）. （2）Along with the advance of hypertension, PP raised gradually and the levels of PP was in order as follows.. group（EH＋TOD）〉group EH〉group Nor （P〈0.01）. （3）There was no significant difference in PP between the two age subgroups of TOD（P〉0.05）. Conclusions The changes of ambulatory pulse pressure can reflect the degree of EH. The obvious increase of PP and decrease of DBP maybe are the exclusive features of ABPM in EH patients with target organs damage.